Synthesis of the Disease Neonatal sepsis may be categorized as early or late onset.

Eighty -five p e r c e n t o f newborns with early-onset infection present within 24 hours, 5% present at 24-48 hours, and asmaller percentage of patients present between 48 hours and 6 days of life. Onset is most rapid in p r e m a t u r e n e o n a t e s . E a r l y - o n s e t sepsis syndrome is associated with acquisition o f microorganisms from the mother. Transplacental infection or an ascending infection from thec e r v i x m a y b e c a u s e d b y o r g a n i s m s t h a t c o l o n i z e i n t h e mother's genitourinary tract, with a c q u i s i t i o n o f t h e m i c r o b e b y passage through a colonized birth canal at delivery. T h e microorganisms most commonly associated with early -onset infection include group B Streptococcus (GBS), Escherichia coli, Haemophilus influenzae, and Listeria monocytogenes. Late-onset sepsis syndrome occurs at 7 -90 days of life and is a c q u i r e d f r o m t h e caregiving environment. Organisms that have been i m p l i c a t e d i n c a u s i n g l a t e - o n s e t s e p s i s syndrome include coagulase-negative staphylococci, Staphylococcus aureus, E coli, Klebsiella, Pseudomonas, Enterobacter, Candida, GBS, Serratia, Acinetobacter, a n d a n a e r o b e s . T h e infant's skin, respiratory tract, conjunctivae, gastrointestinal tract, and umbilicus may becomecoloniz ed from the environment, leading to the possibility of late-onset sepsis from invasivemicroorganisms. Vectors for such colonization may include vascular or urinary catheters, other indwelling lines, or contact from caregivers with bacterial colonization.